delindawilson
New
Can a modifier 80 be used for a vaginal delivery when one doctor delivers the baby and another doctor steps in to do the rest, delivery of placenta, cutting the cord, maternal aftercare, etc?
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Wiki Can a modifier 80 be used on a 59409?
- Thread starter delindawilson
- Start date
Orthocoderpgu
True Blue
I code ortho, according to my Encoder an assistant is allowed, if there is medical necessity to support it.
SharonCollachi
Guest
Curiosity... why would there be two doctors present at a vaginal delivery, and why would one deliver and someone else do the rest?
abbypine
New
for example, mom came into the hospital already pushing and the OB doctor wasn't able to get there in time. The ER doc had to deliver the baby as he is the only doctor available, and the OB doc walks in the room as the baby is being put up on mom's chest and the OB then takes over care. (This happened at our local hospital just last weekend)
SharonCollachi
Guest
Ah, okay, I get it. The original phrasing of "another doctor steps in" sounded like it was planned.
I don't often do delivery coding since I'm gynonc, but yes, this is something that can occur. What you need to keep in mind is regarding the global codes. The code you provided is for the delivery only (not antepartum or postpartum). If you are providing those other services, 59409 does not include that.
With my docs (not often, but has occurred), they are sometimes called in to assist with a CS delivery if there is placenta previa, placenta accreta, excessive bleeding during CS, etc.). Since we are not providing any of the ante/post care and ONLY there for delivery, we code the appropriate delivery -80. And are prepared to appeal if needed.
With my docs (not often, but has occurred), they are sometimes called in to assist with a CS delivery if there is placenta previa, placenta accreta, excessive bleeding during CS, etc.). Since we are not providing any of the ante/post care and ONLY there for delivery, we code the appropriate delivery -80. And are prepared to appeal if needed.
I have never seen an 80 mod with a vaginal delivery, although there could be emergent circumstances that warrant it. The situation you describe does not though. 59409 includes delivery of the placenta. So unless the doctors are not part of the same organization, you couldn't bill that separately. Unless you have other separately billable services, then the 2nd doc would need to talk to management for an internal credit.